Il carcinoma della mammella in gravidanza

Breast cancer is a rare, but frequently hidden pathology. A woman, 36 years old, during the early months of pre- gnancy found a little tumor in her right breast. A fine needle biopsy was negative for cancer. Despite this, the tumor rose and two months after delivery (the patient breast-fed her daughter for a month), she had pain in the right axillary region and the tumors involved all superior dials of the right breast. A Madden mastec- tomy was performed. The histopathological report was: ductal invasive breast can- cer 3 of 19 lymph nodes involved, stage IIIA, TNM pT3N2M0, ER -, PgR +- -. Chemotherapeutic regimens were: at first ADM 75 mg/m2 for 5 cycles, and after CMF 1-8 for 6 cycles. After six months the woman had a cutaneous recurrence in the scar of mastectomy, treated with surgery and RT. Thirteen months after, she had lung MTS and then brain MTS. The patient died thirty months after the mastectomy. The surgeons have to discover the women high-risk for the breast cancer before and during the pregnancy. Excisional biopsy is the diagnostic procedure of choice for breast lump during pregnancy. When a breast cancer develops during a pregnancy, the sur- geon has to operate immediately the tumors. Chemotherapic regimens should be delayed until the second o third trimester or after delivery.

Gli A.A. descrivono il caso di una donna di 36 aa che nel corso della seconda gravidanza sviluppò un carcino- ma della mammella dx. Tale patologia fu sottovalutata durante la gravidanza e solo dopo il parto fu posta la corretta diagnosi. Dopo la mastectomia e i trattamenti antiblastici, la paziente sviluppò, in ordine cronologico una metastasi sulla cicatrice chirurgica, una MTS al pol- mone, poi encefaliche e quindi linfonodali latero-cervi- cali. Morì trenta mesi dopo il primo intervento chirur- gico. Gli A.A. pongono l’accento su di un più attento screening delle patologie mammarie prima e durante la gravidanza, specialmente nelle pazienti a rischio.